This article provides a selected review of several contemporary communication intervention programs for people with developmental disabilities and severe communication impairment. Consideration of the extent and negative effects of severe communication impairment indicates the need for systematic intervention focused on teaching functional communication skills. Behaviour analysis procedures have demonstrated effectiveness for teaching functional communication skills. The major features of several behaviourally oriented communication intervention programs are reviewed. It is concluded that these programs have a sound empirical basis and demonstrated effectiveness for teaching functional communication skills to learners with developmental disabilities and severe communication impairment.

Following on from the American Psychological Association's (1993) findings regarding empirically validated treatments, a British task force (Roth & Fonagy, 1996) arrived at similar conclusions. Both publications strongly endorsed the superior efficacy of cognitive-behaviour therapy (CBT) over placebos, waiting list controls and other psychological treatments. These findings, although not new, are becoming increasingly important as new ways of funding health care become more likely. With these probable changes in health system funding, organisations such as the Australian Association for Cognitive and Behaviour Therapy will almost certainly be asked to provide evidence supporting the efficacy of certain interventions for certain problems, but also to decide who can implement such treatments. This article attempts to present the well known findings within the current framework, and poses an important question: Who can ethically and competently practice CBT?

This review outlines the main theoretical and methodological issues relating to worry. The relationship of worry to anxiety and problem solving is discussed. Three models of worry are described: attention bias (Mathews, 1990), fear avoidance (Borkovec, Shadick, & Hopkins, 1991), and Tallis and Eysenck's (1994) stage model. Worry's proposed role in inhibiting emotional processing is discussed, and unresolved methodological and theoretical issues are considered. It is concluded that worry is elusive and difficult to study but greater understanding of worry is necessary.

The following review paper describes the outcomes of data-based behavioural intervention strategies for the defining characteristics of autistic disorder as defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association, 1994). The results of relevant evaluations of behaviour analytic procedures are reviewed for each of the four potential areas of difficulty under each of the main criteria for autistic disorder, which are: (a) impairment in social interaction, (b) impairment in communication, and (c) restrictive, repetitive, and stereotyped patterns of behaviour, interests, and activities (DSM-IV). The current areas of research activity as well as those domains that have received comparatively little attention by behavioural researchers are identified, and suggestions for future research are discussed.

Recently, the American Psychological Association (APA; 1993) Division of Clinical Psychologists (Division 12) established a task force to define empirically validated treatment and make recommendations in relation to methods for educating mental health professionals, third-party payors, and the public about effective psychotherapies. Predictably, the task force report has a somewhat controversial status but continues to be an influential blueprint for the improvement of clinical psychology in various countries including Australia. The role of the Australian Association for Cognitive and Behaviour Therapy (AACBT) is highlighted in relation to accreditation and mandatory professional development (Australian Psychological Society).

Diagnosis of developmental disability lacks precision, partly because of differences in definitions of the concept, but largely because of problems specific to the use of psychometric measures with children who have a developmental disability. These problems arise from inadequate evidence of reliability for psychometric measures at extremes of the normal distribution, from lack of comparability between different tests and between different editions of tests, and from practical considerations in the assessment of people with various disabilities. Adaptive behaviour assessment has been introduced to supplement intelligence testing, but lack of a clear conceptualisation of this concept and doubts about the appropriateness of United States norms for Australian children add to the difficulties of interpreting results of standardised scales. Systematic assessment of behavioural problems needs to be incorporated into diagnostic procedures. This paper argues that improvements in the accuracy of diagnosis are unlikely to come from further technical advances in psychometric assessment, and suggests that diagnosis in the future should take into account new technologies which link etiology to specific behavioural patterns to supplement existing procedures.

This paper reviews the recent behavioural research on instruction of children and young adults with mental retardation in schools settings and community-based school programs. Instructional research in 12 skill areas (motor, self-care, communication, social skills, choice making, school behaviours, health and safety skills, home management, leisure skills, community use, vocational skills, and academics) meeting specified criteria on population (age and disability), location of instruction, functionality of skill, and research integrity was identified in 11 journals from 1990 through 1996. The pool of identified research is discussed by skill category and by intervention method, with critical comments made regarding strengths and weaknesses. Conclusions are drawn for practitioners and future researchers.

Whereas King's (1977) focus was clinical psychology, the present commentary considers empirical validation of psychological practice in health settings. Comparisons are made with the fact that most diagnostic and therapeutic medical practices in use have yet to be empirically validated. At the population level, modern medicine does not appear to have had a large impact on any of the major causes of premature death, past or present. Conversely, there is strong evidence that all current major causes of death are closely related to behaviour pattern. However, there are formidable obstacles to the uptake and future development of behavioural interventions in health settings. Issues subsumed under the rubric of quality of care are particularly important, including appropriateness (treatment should not be applied when it is not needed — avoidance of overservicing), and necessity (treatment should be available to persons in need — avoidance of underservicing). The general public, health practitioners, and health policy makers are relatively uninformed about relevant psychological practices and about the central role of psychological processes in all aspects of human health.

In recent years there has been an abundance of research highlighting the pre-eminent status of phonemic awareness in the development of reading capability. This paper examines the concept of phonemic awareness, and reviews recent findings pointing to its causal links with reading. The importance of linking reading instruction with phonemic awareness is explored, as is the significance of early identification and intervention. Finally, obstacles to systemic implementation are considered, in conjunction with the bleak prognosis for students with a history of early reading failure.

The study examined associations reported by carers between problem behaviour of 92 adults with intellectual disability and 169 antecedent events, which were either environmental situations or prior behaviours of the client. Factor analyses were used to identify groupings of antecedents, providing a basis for constructing 19 sets of antecedents of problem behaviours. Assessments were made of the psychometric properties of these sets of items or scales. Of the 19 scales, 18 were associated with an increased likelihood of problem behaviour, showing that carers reported that the problem behaviours of this sample occurred in a wide range of defined situations. The preliminary analysis suggests that the scales may be useful for inquiring more systematically about antecedents, for developing descriptions of situations where problems occur, and for identifying situations that warrant further analysis in individual cases.

The concept of empirically validated treatments is an attempt to focus psychological training and practice on treatments that work. In this paper, I examine the complexities of defining the concept with reference to the treatment of relationship problems. The key criterion employed to define a treatment as empirically validated is established efficacy within controlled trials. I suggest that the criteria need to be expanded to include assessment of the variability, clinical significance, and durability of treatment effects, the relative efficacy of alternative approaches, and the ease of dissemination of treatments. Whilst few, if any, psychological treatments currently have data on whether they meet all these criteria, I suggest that setting these more ambitious criteria will direct us towards the ultimate goal of offering better psychological treatments.

A structured diary was used to collect information about the informal peer interactions of 536 children in their final year at nine primary schools. Measures of self-concept, social avoidance, and popularity were also taken. Initially, seven different scores were derived from the information contained in the diary to produce the Adolescent Social Interaction Profile (ASIP). Previous research with the ASIP subsequently identified three factors labelled scale, scope, and enjoyment of peer interactions, that were separate from a fourth generic self-concept factor derived from self-report questionnaires. Inspection of the factor scores for 19 children with full data sets who received the fewest peer nominations showed considerable heterogeneity, with only 1 child scoring low on more than two of the four factors. More expedient composite scores were then derived that reflected the factor loadings for the two complex ASIP scores labelled scale and scope. The utility of these scores for identifying and monitoring specific aspects of peer interaction difficulties is discussed.

We examined the prevalence of comorbid psychopathology, family psychiatric history, and perceptions of family environment in 20 women with binge-eating disorder (BED) and 20 non-binge-eating obese controls. Women with BED were significantly more likely to report current or lifetime affective and anxiety disorders as well as family histories of BED. Family histories of substance abuse did not differ across groups. Significantly more women with BED rated their parents' parenting style as consistent with “affectionless control” on the Parental Bonding Instrument, and reported significantly lower cohesion, expressiveness, conflict, independence, intellectual-cultural orientation, and active-recreational orientation on the Family Environment Scale.

Sexual offences against women and children constitute a serious and distressingly prevalent social problem. The psychological and emotional costs to victims and their families, the high reoffending rates of some types of offenders, and the financial costs of incarceration all highlight the urgent need for effective research and treatment of this problem behaviour. In the past two decades, a number of innovations have led to improved treatment of these difficult men. In addition, theories and models have been developed with the aim of furthering our understanding of sex offenders. In this paper we identify a number of issues within the broad areas of assessment and treatment that we believe to be problematic, and make some suggestions about ways of resolving these problems in the future.

The employment of untrained paraprofessionals to support children with disabilities in educational settings is not uncommon. Although urgently needed, research on effective methods of increasing the skills of these paraprofessionals is scarce. This study, which was conducted over 3 academic years, assessed the effectiveness of incorporating naturalistic prompting strategies by paraprofessionals for increasing target communicative behaviours of students with severe spastic quadriplegic cerebral palsy. A concurrent multiple-baseline design replicated across 3 paraprofessionals was used to determine the effectiveness of verbal and written feedback regarding their attainment of self-selected goals for prompting target communicative behaviours. The results indicate that, after the introduction of the intervention, the prompting behaviours of all paraprofessionals increased, as did the target behaviours of all students. Increases maintained 5 months after intervention for all students observed and for 2 of the 3 paraprofessionals observed. The implications of designing a program to include specific performance feedback and active involvement by staff are discussed.

This commentary argues that empirically validated treatments for child and youth behaviour and emotional difficulties are available, but they are relatively inaccessible to the vast majority of Australian children and their families. Although effective interventions have been developed, few children receive these services. There are many children who have identifiable problems or who are at increased risk for psychosocial problems whose needs have not been adequately addressed by either the research or the professional community. These include children in rural and remote areas, Aboriginal and Torres Strait Islander children, children of migrants, and children with chronic physical illnesses. A comprehensive, preventively focused clinical science of prevention is needed to improve the reach and impact of psychological services for children.

Information-processing speed and cue reactivity were evaluated in women with bulimia nervosa and controls in response to neutral, mood, and food cues in isolation, and mood and food cues in combination. Significant differences were consistently observed between women with bulimia nervosa and control women on information-processing speed for food/body-related words, but not for words unrelated to food/body concerns. As expected, women with bulimia nervosa demonstrated slower processing of information related to food/body concerns. In addition, the presentation of mood and food cues affected speed of information processing. Especially for women with bulimia nervosa, information processing was slowest when either mood or food cues were presented in isolation. Significant cue reactivity was also observed, again especially for women with bulimia nervosa. In conclusion, both transient and more enduring subject characteristics affected information-processing speed. Moreover, the way transient factors were presented significantly affected speed of information processing. This suggests a more complex relationship between cue presentation and information processing than was anticipated.

A case study is described to illustrate the need for vigilance in detecting drug-induced headache. A woman (“Jane”) volunteered for a headache research program, and assessment revealed a very high consumption of headache medication. Jane was taking an average of 21 tablets per day as well as receiving injections several times a week. The research staff directed her to record her medication, and to take these records to her doctor for review. Two general practitioners and a psychiatrist responded that there was no need for intervention, but the researchers were sufficiently concerned that they encouraged her to find another doctor. The fourth doctor admitted her to hospital immediately for detoxification with spectacularly beneficial results.